Families affected by pediatric acquired immunodeficiency syndrome: sources of stress and coping

This study explores stress and coping among inner-city, ethnically diverse families with human immunodeficiency virus (HIV)-infected children. Caregivers, siblings, and HIV-infected children from 25 families responded to a semistructured interview on the psychosocial impact of HIV. Families were primarily African-American and Latino and from low socioeconomic-status backgrounds. Approximately one third of the children lived with an HIV-positive birth parent, one third with a grandmother, and one third in foster or adoptive care. The majority of caregivers were single mothers who confronted major life events and who were overextended with caregiving responsibilities. Compared with uninfected caregivers, HIV-infected parents reported more isolation and fewer financial and support resources. All children were particularly vulnerable to separations and loss, with uninfected siblings reporting anger and burden from caregiving tasks. Although some families had coping resources, many families might benefit from family-focused mental health services, particularly those that reduce isolation, promote family functioning and provide respite care.